During the Association of Clinic Biochemistry in India
Prof. Dr. Gustavo Zubieta-Calleja was addressed for the first time in 2017 as THE HYPOXIA MAN by Prof. M.L.B. Bhatt the Vice-Chancellor of King George’s Medical University in Lucknow India shown above during the Inauguration of the Asociation of Clinical Biochemists International Conference (ACBICON).
India is one of the most beautiful countries in the world. Its biodiversity, love, and respect of all living beings and its kindness and hospitality, never stop surprising me. Five times have I visited India, thus far. Three with my late father Prof. Dr. Gustavo Zubieta-Castillo, the Mountain Guru!
Prof. Thuppil Venkatesh, The Lead Man of India has been instrumental. We met at the 4th World Conference on High Altitude Medicine and Physiology in Arica, Chile in 2000. The President of that meeting was Klaus Behn, a fine man, that we have never seen again, although we would love to do it. He had invited my father to be one of the 3 Keynote Speakers. His theme was Chronic Mountain Sickness. Unfortunately, a Peruvian lady imposed her presence and my father was obliged to share his presentation.
Prof. Venkatesh is the current President of the International Society of Chronic Hypoxia. Prof. Dr. Gustavo Zubieta-Calleja (Jr) is the Vice-President.
It is interesting to point out, that during the ACBICON 2017 conference, Gustavo Jr had not taken a suit to his 4th visit to India. Prof. Venkatesh kindly lent him a blue coat, which is shown in the picture above.
Outside King George’s beautiful Vice-Chancellor’s office we share some wonderful moments with Prof. (Dr.) Farzana Mahdi , Vice-Chancellor of Era University, and our dear friend Dr. Hari Sharma Professor at Erasmus MC in Belgium.
During a wonderful visit to Prof. M.L. Bhatt, Vice-Chancellor’s at the King Georges’s University in Lucknow, India, we discussed many interesting aspects.
During his second visit to the new Vice-Chancellor of King George’s University
It is with great sadness that we communicate the loss of a great man, a great leader, a great educator, a great physician, a great Vice-Chancellor, and a great friend: the DistinguishedDr. M.S. Biradar.
He leaves an empty space physically and in all our brains, and with great sorrow because we did not learn, all we could from him. He was profoundly philosophical, kind, sweet, and wise! Few have such distinctions in life!!!
The HIGH ALTITUDE PULMONARY AND PATHOLOGY INSTITUTE (HAPPI-IPPA) from La Paz, Bolivia, honors his memory from here into Eternity!!
During our visit with Jan Marino Ramirez to BLDE University. From left: Kusal Das, Jan Marino Ramirez, Dr. M.S. Biradar, Gustavo Zubieta-Calleja, Dr. Patil. From the left: Prof. Kusal Das, Dr. M.S. Biradar, Erika Ramirez, Natalia Zubieta-DeUrioste, Rafaela Zubieta-DeUrioste, Gustavo Zubieta-Calleja, Jan Marino Ramirez, Thuppil Venkatesh
Please see the beautiful Condolence messages from World leaders of Medical Sciences:
During the 7th Chronic Hypoxia Symposium Opening Ceremony with the participating Institutions: Jorge Soliz, Laval University, Thuppil Venkatesh, President of the International Society of Chronic Hypoxia, Gustavo Zubieta-Calleja, Head of IPPA, Commander Gonzalo Jarjuri, Prof. M.S. Biradar BLDE Deemed To Be University, India, the Vice-Commander of the Bolivian Navy and Dr. Natalia Zubieta-DeUriosteThe participation of 16 countries: Australia, Cezch Republic, India, Mexico, USA, Peru, Ukraine, Canada, Colombia, Chile, England, Bolivia, Kyrgistan, Italia, Ecuador, DinamarcaDuring the candle lighting ceremony, following the Indian Tradition, a first in the History of Bolivia
The local Newspaper EL DIARIO publication MARCH 3, 2019 can be found here
El uso de la palabra polieritrocitemia creado por el Prof. Dr. Gustavo Zubieta-Castillo se esta generalizando.
Los Doctores Gustavo Zubieta-Castillo y Gustavo Zubieta-Calleja fueron invitados a participar en el 6to Seminario Internacional de Salud Ocupacional en operaciones mineras llevado a cabo el 23 y 24 de octubre de 2014, en Lima, Peru. En esa oportunidad el Dr. Zubieta-Castillo hablo sobre la polieritrocitemia, sus causas y sus tratamientos. El Dr, Zubieta-Calleja habló sobre la hipoventilacion en la altura y sus efectos.
Una disertación en la Universidad Nacional de Cajamarca para el titulo de Médico Cirujano:
On one of our trips to Europe invited to give talks, my father Prof. Dr. Gustavo Zubieta-Castillo and myself were going by train from Madrid to Paris. Close to the north border of Spain, in a beautiful sunny day, we both stared out the windows and suddenly the magnificent Playa de la Concha appeared. We were breath-taken by its beauty and by the prettiness of the town next to it. My father immediately exclaimed: “I truly want to come here!!” and we continued the trip to Irun the border and then on to Paris.
Much to my surprise around 3 months later we get an e-mail from the Federación Vasca de Montaña, signed by Dr. Ramón Gárate. They were inviting us to present a paper (both of us) on behalf of the director Paco Iriondo.It was the 75 Anniversary of the FEDERACION VASCO-NAVARRA DE ALPINISMO (EUSKAL MENDIZALE FEDERAKUNDEA) celebrated in Donostia, San Sebastian on October 15th de 1999.
My father was not only a visionary but also remarkable in getting what he desired. This was a typical outcome, again and again.
Several months later, we were again heading to Europe but this time to San Sebastian!! Arriving at the airport and meeting Ramón Gárate and his collaborator was a true delight. They were kind and very friendly, as we had met a long time before. They drove us to a small beautiful wooden refuge in the curvy green surrounded areas named Abeleche. There the administrator Juancho greeted us and prepared a fantastic lunch with Jamón Serrano, and kinds of delicious sea food. I don’t believe we had ever enjoyed such a magnificent sea food delight and perhaps it was never repeated in our joint lives.
The Conferences, where my father talked about “Pulmones y Altura” and I “El Corazon y la Altura”, went on very nice with a couple of Spanish Colleagues who also presented their work. It is interesting to note that they asked us to also write a manuscript and they gave us each a good payment that allowed us to travel to London right afterwards and visit the Royal Academy.
With the Spanish colleagues that were also co-speakers. Left-to-right: Gustavo Zubieta-Castillo, Conxita Leal, Carlos Villas, Antón Rañé, Gustavo Zubieta-Calleja.Visiting and having a wonderful conversation with the president of the Royal Society in London
The papers were handed over to them and were later published at ResearchGate.net. Interestingly, we had hardly published scientific articles in Spanish as we always thought that the worldwide distribution was important. What is outstanding is that the “El Corazon y la Altura: Función cardiaca y adaptación” has over 38,500 reads as of the time of writing this article (Feb 14, 2021).
“Pulmones y Altura” has just been uploaded to ReserachGate.net
Our dear friends took us all around and we were surprised to find that the Avenue in front of the Playa de la Concha is called “Zubieta”. We then visited the Zubieta Bridge and the Town of Zubieta. What a delight all that was! We had learned of our roots and probably where our adventurous in science genetic driving spirit came from. They also gave us some guides
showing our background, and along two black boinas vascas txapelas. We remained extremely impressed the beauty and organization of the Vasque country. They also gave us a book on Vasque climbing the Ochomiles mountains.
In front of the Zubieta Bridge
Here, I found a link to our old Geocities website with comments of our historic participation. YOU MUST VISIT IT!!
In any event, this metaphysical phenomenon, that crystallized when my father affirmed “I truly want to come here” still makes me wonder in fascination !!!
International Conference on Coronavirus Viral Genomes Oct 2020 Bangalore, India.
Prof. Dr. Gustavo Zubieta-Calleja, M.D., FPVRI
Head, High Altitude Pulmonary and Pathology Institute – (HAPPI-IPPA)
La Paz, Bolivia
COVID is a dramatic terrible disease for around 5% of the population, causing great sorrow, pain, and suffering. Yet, we have to be positive and we must try to understand deeply the CoV-2, that we are all facing. The Second World Covid Conference we organized jointly with between Prof. Dr. Gustavo Zubieta-Calleja and Dr. Natalia Zubieta-DeUrioste from High Altitude Pulmonary and Pathology Institute (HAPPI-IPPA) and Dr. Malali Gouda and Dr. Pruthvi Chakravarthi the Bengaluru Genomics Center (BGC) was a gathering of notable scientists, from around the world like Kusal Das, Thuppil Venkatesh, Malali Gowda, Robert Gallo, Murray Epstein, Andrew Pollard Giuseppe Miserocchi, Oscar Murillo, Paolo Pelosi, Augusto Ittig, V. Ravi, and so many other excellent speakers. It was a wonderful opportunity to exchange ideas, to give all our knowledge in what we understand was the first International Conference on COVID in India. The speakers made it a goal to find solutions, suggest ideas, propose therapies with great originality to improve our world. I found myself delighted by the exchange of ideas, the learning, the reasoning, and I am certain it is a remarkable contribution to the world.
Did we shed some light on the Coronavirus Pandemia shaking the world? After all, the scientific conferences in India always start by jointly lighting a multiple wick oil lamp in order to find illumination. I had previously been invited to the International Conference on COVID Genomics Bangalore on June 7-10th 2020 in this conference organized by Dr. Malali Gowda and his collaborators Dr. Pruthvi Chakravarthi and Dr. Preenon Bagchi. He has set his life goal to improve the environment through genetics, making it greener, more ecologic, and hence filled with oxygen, our luxury precious element of life on our planet Earth.
A virus is an RNA strand encapsulated in a protective sheath composed of proteins. We can understand that this structure is essential for its survival and its transport. Most affirm that it has no life and it is a subject of interest(Villarreal, 2004). But, what is life? Life is defined as having the following properties: Organization, Metabolism, Homeostasis, Growth, Reproduction, Response, and Evolution(Academy, 2016). Let us analyze each one.
Organization: living beings contain specialized coordinated parts, i.e. cells. But are cells necessary? Coronavirus is in a way like a cell. They have a nucleus: RNA and they have an outer sheath, which has a special corona shape. Are they organized? Do we know if they communicate between themselves? It would seem not with our current understanding of communication. But there are many things we don’t know or much less understand thus far. They are composed of atoms that build amino-acids composing the RNA. Do we fully understand the atoms? We continue to find particles within them thanks to immense cyclotron colliders. The coronavirus is a nucleic acid genome surrounded by a protein sheath. What is in-between? nothing? emptiness? space? molecules?
Metabolism: Chemical reactions that allow the living organism to move and catch a prey. The shape of the coronavirus is very peculiar. It measures 120nm and has spikes that provide it with several properties: self-protection, adhesion to surfaces, connection “hooks”, and possibly even air flotation qualities, like an airplane. It reduces the contact surface area. Probably that is why it survives so long on many surfaces (the least time in copper, possibly due to its atomic electrically charged characteristics). Consequently, they move and furthermore, they have a prey: it is us humans. Anabolism is making complex molecules from simpler ones. They use molecules within cells. Catabolism; they have their energy. How can they survive days on surfaces? Perhaps they obtain their energy from molecules?
Homeostasis: Coronavirus regulate their internal environment to maintain a relatively narrow range of conditions, otherwise they would not exist.
Growth: it implies creating proteins and DNA. Well, in this case, it is RNA and the outer sheath, also its protein growth.
Reproduction: This is what they do best within our cells. The question is what drives them? Humans and animals have the sex drive: a sweet intuitive compulsive sensation. All insects must have this same drive. Bacteria, fungi, and other organisms probably do too. Why not the Coronavirus? Is there an intricate drive for reproduction within them that we still don’t understand? They certainly move fast to replicate themselves, within us.
Response: The capability to respond to stimuli. Antibodies block and destroy them, so they mutate. That is a response.
Evolution: mutations, adaptation to the environments allow for its survival. The spikes are resources of evolution. The entrance through the ACE2 receptors is a coordinated “well-calculated” mechanism that allows them to enter the cells and re-code the lysosomes changing the genetic code for mass replication of its code.
I believe that the Coronavirus is a striking mystery filled with life. And I even think that somehow it has intelligence that challenges that of all humans.
Source: CDC
What has the COV-2 come to do to our planet? It has shaken the very foundations of our society. I find it a fascinating composition of nature. Humans had begun to think that they could dominate nature. That they were superior to all living beings. (apparently, not this one so far). Humans could kill animals, destroy forests, kill other humans, and even try to create life. However, this last task has not been easy, and thus far unsuccessful. Nature had been working for 13.8 billion years ago since the Big Bang (we assume). The molecules arrived on our planet from distant stars and created the most beautiful and precious music: the symphony of life. It is an insolence of humans to think they could dominate nature in so little time of human existence of around 3 million years, and with true development of science and technology only for the past thousands of years.
There is the intention of “Terraforming” Mars (changing it to be like earth). They had even forgotten man and all living beings in this quest, so I created the term “BioSpaceForming” (Adaptation to life in Space)(G. R. Zubieta-Calleja & Zubieta-DeUrioste, 2018) to understand the changes living beings will have to undergo, without a doubt. Adaptation = survival. And that is what Cov-2 does.
BioSpaceForming
And then comes the behavior of humans on planet Earth. They based life on gain and greed. Even going beyond nature’s interests, other beings’ interests, and even other humans’ interests. The quest has wrongly been for money, money, money. The psychology of creating war to dominate others is a pathological mental derangement. Sometimes merely for pride and for the simple feeble-minded attitude of destruction, itself.
So, is the coronavirus a mere random and accident of nature or is it a preprogrammed biological weapon? It seems like a Bio-Nuclear attack(Gustavo R. Zubieta-Calleja, 2020). It biologically attacks our cells and mostly our life-sustaining cells located in our lungs. It enters the cells through the ACE2 receptors and reproduces itself within, creating the birth of thousands of new offspring breaking and destroying our life-sustaining cells in our lungs. It creates what I have called and mentioned publicly for the first time at this conference “pneumolysis” (Lung destruction), thereby depriving us of the fundamental organ with which we capture the oxygen molecules from the air. The rapidly progressing “silent hypoxia” can be aggravated by a superimposed High Altitude Pulmonary Edema-type reaction. Those affected severely by this COVID are suddenly taken to the hypoxic levels of Mt. Everest(Gustavo R. Zubieta-Calleja et al., 2020). With insufficient time for adaptation, without enough blood, with excess carbon dioxide, (the fundamental Tolerance to Hypoxia factors)(Zubieta-Calleja, G.R., Ardaya, G., Zubieta, N., Paulev, 2013), respiratory acidosis and possibly metabolic acidosis results. The severe hypoxia is aggravated by accumulating hypercapnia (due to insufficient gas-exchange area) inducing severe dyspnea and “gasping”. This acute pulmonary insufficiency takes the most precious gift of nature: life.
This surprise attack on our bodies has shaken the most advanced societies with all their supposedly superior know-how, and created havoc in them. Immense amounts of money were useless in the richest countries. The rich became equal to the poor. Pre-established protocols in hospitals were inefficient and often deadly. Quarantines were established in order to attempt survival. The economies of all countries are now severely compromised. But going back, was all the social and economic “development” necessary? Does nature see it as “progress” or self-destruction? Is nature teaching us a lesson? Is it punishing us? Is this truly a random event? Is it biological cleansing of the weakest?
Can we defend ourselves? What are the components of our armor? It seems more and more evident that our most important defense tool is intelligence. The creation of vaccines is underway, but it is plagued with time constraints and many doubts. The appearance of all types of medication in search for the miracle cure, keep turning unsuccessful. The pharmaceutic industry shows its real face of inefficiency as it is often based on propaganda, biased results, discrediting simple medication, manipulation of data, often resulting more lethal than curative. The manipulation of food through the use of chemicals has turned world food not nutritive and healthy but rather poisonous, causing cancer, metabolic disease and suffering. We have all polluted the world mercilessly. From the medical point facing COVID-19, some weaknesses become more and more evident: Type A blood, chronic inflammation, stress, multiple sicknesses, lack of hygiene, old age, dysfunctional organs, etc. We still have a long road ahead.
Delayed presentation and lower incidence of COVD-19 at high altitude where U-V is higher
High altitude with its high ultraviolet radiation along with biological adaptation proves to be one of the most effective armors. The Sun’s rays become our protectors, sterilizing our environment when falling on all surfaces destroying the Coronavirus (and hence reducing contagion)(G. Zubieta-Calleja, n.d.), and likewise building Vitamin D when falling on our skins. Biological adaptation such as the decreased ACE2 receptors, in the lungs at high altitudes may play a role in reducing the incidence up to 10 times less, with respect to sea level, all around the world(Arias-Reyes et al., 2020). It is safer to be at high altitude in this Pandemia.
Our only true defense mechanism is our immune system, that has been constantly attacked by medication, chemicals in our food, contamination of our water, all responding to ambition and economical greed. The truly useful medications become the prompt use of nature’s, good hydration, good healthy nutrition, and several natural components coming from plants, salts, metals like Iodine, copper, natural anti-inflammatories like AcetylSalicilic Acid, Aspirin, Curcumin, antibiotics and a good amount of iron in our blood as that naturally granted to us in the hypoxic environment at high altitude, thereby increasing the oxygen pool reserve for the moment of the most critical lung compromise. Many other natural medicines will surface. But in the meantime, we must be careful, use face masks, wash our hands, avoid multitudes, keep social distancing, and us scientists continue our research.
Perhaps, in the end, the remedy lies in respecting natural knowhow like the Ayurveda, the peace of mind in Yoga, the humbleness of Buddha, the kindness teachings of Christ, the generosity and love of Ganesha, the true values of man, not based on wealth, not based on religious or political domination but rather on respect for nature, harmony with nature, love of all living beings. That is what India teaches us. After all, we are all living only a very short period in time in our universe.
References
Academy, K. (2016). What is life? https://www.khanacademy.org/science/high-school-biology/hs-biology-foundations/hs-biology-and-the-scientific-method/a/what-is-life
Arias-Reyes, C., Zubieta-DeUrioste, N., Poma-Machicao, L., Aliaga-Raduan, F., Carvajal-Rodriguez, F., Dutschmann, M., Schneider-Gasser, E. M., Zubieta-Calleja, G., & Soliz, J. (2020). Does the pathogenesis of SARS-CoV-2 virus decrease at high-altitude? Respiratory Physiology and Neurobiology. https://doi.org/10.1016/j.resp.2020.103443
Villarreal, L. P. (2004). Are Viruses Alive? Scientific American, 101–105. https://doi.org/https://doi.org/10.1038/scientificamerican1204-100
Zubieta-Calleja, G.R., Ardaya, G., Zubieta, N., Paulev, P. E. & Z.-C. G. (2013). Tolerance to Hypoxia. J Fisiol. https://zuniv.net/pub/TolerancetoHypoxiaFiziol.pdf
Zubieta-Calleja, G. (n.d.). The advantages of ultraviolet radiation in controlling the coronavirus at high altitude. La Razon. http://altitudeclinic.com/blog/2020/04/u_v-radiation-covid-2-at-high-altitude/
Zubieta-Calleja, G. R., & Zubieta-DeUrioste, N. (2018). Space travel in a high-altitude environment. One more step in human BioSpaceForming. BLDE Univ J Health Sci, 3, 97–103.
Zubieta-Calleja, Gustavo R. (2020). Co-Vid-19 Pandemia Essential Suggestions. March 19. http://altitudeclinic.com/blog/2020/03/covid-19-pandemia-essential-suggestions/
Zubieta-Calleja, Gustavo R., Zubieta-DeUrioste, N., Venkatesh, T., Das, K., & Soliz, J. (2020). COVID-19: Multiple Diseases Simulating Extreme High-Altitude Exposure? Oxygen Transport Physiology and Scarce Need of Ventilators; Andean Condor’s-Eye-View. https://doi.org/10.20944/PREPRINTS202005.0085.V1
Instituto Pulmonar y Patología en la Altura (IPPA)
English version below
Nuevamente estamos en Octubre, cuando nuestros cielos se llenan de rayos solares maravillosos en toda Bolivia, pero…. ¿Chaqueos de nuevo? ¿Humo de nuevo? ¿Ciudades con el aire contaminado?
Este planeta es hermoso. Es el producto estrella del Universo. Todavia no hemos descubierto la vida fuera del planeta. ¿Se dan cuenta todos lo extraordinario y fantastico que esto es?
La tecnologia y la ciencia han avanzado a grandes pasos, sin lugar a duda. Los celulares, las computadoras, el vuelo, incluso el ir a la Luna. Notables logros de la inteligencia, la tenacidad, el esfuerzo de grandes hombres. Pero esos logros en perspectiva, son infinitesimalmente insignificantes, frente a la grandeza de la naturaleza. Uno de los elementos mas esenciales de la vida, es el oxigeno. Los humanos, los seres vivos, mas inteligentes del planeta, y quizas, aunque suene demasiado audaz, de todo el Universo, necesitamos de este precioso elemento: el oxígeno. Curiosamente, el oxígeno que respiramos, no fué producido en la tierra. Lo fabricaron grandes explosiones en el espacio. La tierra fue la ganadora de la loteria de su distribucion y su mezcla con temperaturas adecuadas, y otros elementos vitales. Llego atravesando espacios casi ilimitados para posarse en un planeta donde tambien hay agua, y todos los otros elementos preciosos de la vida. Pero es el oxigeno, el mas vital, por ser el que no puede ser guardado en el organismo. Podemos dejar de comer solidos y sobrevivir hasta un mes, dejar de ingerir liquidos y sobrevivir 1 semana. Pero dejar de respirar e inhalar el oxigeno solo podemos hacerlo unos 3 a 5 minutos. Si no ingresa a los pulmones el aire con 20.9% de oxigeno, estamos frente a la muerte. Es por eso que este elemento precioso, no tiene precio. Vale mas que el oro, pues el Coronavirus lo ha demostrado ampliamente. Podria ser el hombre mas rico, pero si no entraba suficiente oxigeno a la sangre para nutrir a los tejidos y a nuestro cerebro, todo se acabó. Es el fin a pesar de estar hechado en una cuna de oro.
Como médico especialista en medicina de la altura y habiendo trabajado durante 50 años a lado de mi Padre el Prof. Dr. Gustavo Zubieta-Castillo fundador de el Instituto Pulmonar y Patología en la Altura (IPPA), considero mi apremiante responsabilidad dar los mas importantes y urgentes consejos.
Desde el inicio de la Pandemia en Wuhan, China, me he visto atrapado como en una avalancha dedicando mi atencion y todos mis conocimientos, a lado de mi hija Natalia, medico de profesión al frente de batalla creado por este terrible Coronavirus-2 que desencadena la enfermedad denominada COVID-19. Recibi una gentil invitacion para participar en un programa radial sobre el Coronavirus en Enero de 2020. Mi primera reaccion fue la de rechazar la invitacion porque afirmé que yo no era epidemiólogo y realmente no sabia mucho de esta enfermedad, “colgando” así el teléfono. 5 minutos transcurrieron y volvieron a llamarme. Nuevamente escuché la amable voz de Jackeline Barriga, quien habiendo comunicado mi decision a Johny Villaroel gestor de la invitacion y director del programa Desarmado Discursivo, me decia que realmente querian que participara y diera mi opinion. Aparentemente, una previa entrevista en la radio de la UMSA, le habia agradado y sentía que yo deberia participar, junto al Dr.Nestor Taboada, el otro entrevistado. Reflexionando, acepté y ello cambio el curso de mi atencion y enfoqué todos mis esfuerzos a entender mejor a este tremendo virus con el único objetivo de salvar vidas.
En vivo, propuse la idea, de que las personas infectadas que llegaran al aeropuerto de La Paz, deberian ser aisladas en un reciento alejado de la ciudad y en el altiplano para evitar la progresion de la enfermedad. Ademas aduje, que la radiación ultra-violeta que se encuentra en niveles extremos en la altura, seria una ventaja frente al Coronavirus. Esa ultima afirmacion, basada en el concepto de las ventajas de la radiacion ultra-violeta en la altura como anti-baceriano, la había hecho 2 años antes en una publicación donde demostraba la longevidad extendida del hombre en la altura, comparada con los habitantes del llano, basado en un estudio de datos provistos por el SEGIP (https://www.zuniv.net/pub/Longevidad_Espanol.pdf). Posteriormente el 5 de Abril, 2020 publiqué un articulo en La Razón, en Marzo, donde afirmé que la radiación ultra-violeta nos protegería del COVID-19. Y evidentemente la progresion fue mas lenta en la ciudad de La Paz y el Alto inicialmente. Sin embargo, en Julio hubo un incremento importante de casos, que de todas maneras no llegaron nunca a sobrepasar los de Santa Cruz, aunque ambos departamentos cuentan con un numero similar de habitantes (La Paz, 2.9 M y Santa Cruz 3.37 M). Este incremento se dió porque en invierno la radiacion ultra-violeta está en su punto más bajo. Pero luego del solsticio de invierno, gradualmente fue aumentando la radiacion ultravioleta y concomitantemente empezaron a disminuir los casos de COVID-19, como vaticinamos. La incidencia de la mortalidad también es más baja en la altura, como lo confirmamos con el Dr. Freddy Armijo Subieta en varias oportunidades. La altura, sin duda alguna, es un protector contra la agresividad del Coronavirus, no solo por las caracteristicas ambientales, sino tambien por las caracteristicas biológicas de adaptación a la altura. Publicamos varios articulos científicos en revistas internacionales al respecto.
Cuando las publicaciones del exterior afirmaron que en Nueva York, en los hospitales mejor equipados del mundo, la mortalidad de los que estaban con ventiladores era de 88.7%, me pregunté: que esta ocurriendo en los pulmones con la agresion de este virus? Inmeditamente, me dí cuenta que no estabamos frente a una neumonia típica tipo SARS, como aducian los expertos de todo el mundo. Estabamos frente a una nueva enfermedad. Desarrollé la idea nueva para todo el mundo, de la neumólisis, la destruccion de los pulmones ocasionada por el virus. Lo mencioné por primera vez en la primera conferencia del Coronavirus en la India, donde fuí invitado a participar y colaboré activamente invitando a otros colegas. Se lo mencioné al profesor Italiano Paolo Pelosi autoridad mundial en ventilacion mecánica. El habia tratado a multiples pacientes en las unidades de trapia intensiva en toda la catastrofica pandemia en su país y todavia no comprendian claramente que ocurria. El 9 de Julio,2020 (coincidiendo con el 50 anniversario del IPPA) el periodico El Diario me hizo una entrevista y alli hable en Bolivia por primera vez de la Neumólisis. Luego fuí invitado a ser co-director del 2do Congreso mundial de Avances en el COVID con el Prof. Malali Gowda del Bangalore Genomics Center en la India. Llevamos a cabo dicho exitoso evento del 27 al 30 de Agosto, 2020 con presencia de grandes científicos como el Dr. Andrew Pollard, un amigo, director de la Vacuna de Oxford, y el Dr. Robert Gallo, uno de los descubridores del virus del SIDA, entre otros notables cientificos, a quienes invité. Allí expuse en más detalle la Neumólisis y la hipoxia silenciosa (baja del oxigeno), que puede llevar a la muerte subita. Hablé no solo de los estudios microscopicos sinó de la fisiopatologia de esta terrible enfermedad. El Prof. Pelosi presentó pruebas adicionales de la neumólisis, confirmando su existencia. Lo invité a dar con mi persona, 2 conferencias aquí en La Paz. Tambien publicamos con mi hija Natalia, sobre la neumólisis en el Boletin Nacional de Bioetica, dirigido por el Doctor Javier Luna Orozco.
El nuevo concepto “Neumólisis” desarrollado por mi persona, en referencia al compromiso serio ocasionado por el Coronavirus en la actual pandemia del COVID-19, se constituye en un factor de gran riesgo en esta epoca. El Coronavirus ingresa al pulmón por via inhalatoria y se anida ingresando por los receptores ACE-2 en los neumocitos (las celulas respiratorias en el pulmón), el material RNA del virus se reproduce y ocasiona la destrucción de estas celulas: Neumólisis (neumo=pulmón, lisis=destrucción).
neumólisis en COVID-19
Es por eso que se produce una lesión severa de diversas partes del pulmón (zonas blancas en la tomografía), ocasionando un descenso del nivel de oxígeno, evidenciado por el pulsoximetro digital. Los pulmones de los pacientes se van destrozando gradualmente conforme el virus se propaga y llegan a producir la “hipoxemia silenciosa o silente”. Hipoxemia (hipo=baja,oxemia=oxígeno en la sangre) que se mide con el pulso-oxímetro.
Volviendo a los chaqueos, en estas circumstancias el humo en el ambiente, es un factor seriamente agravante compromitiendo la salud, particularmente de los que no tienen acceso al oxígeno medicinal, lo que puede costarles la vida. El humo, además bloquea el ingreso de la luz solar, y por lo tanto, la radiación ultra-violeta que nos protege del coronavirus como lo afirmé en el articulo: Las ventajas de la radiacion ultra-violeta en el control del coronavirus en la altura (La Razon, 5 de Abril, 2020). Y recientemente a sugerencia del Físico Roberto Vera, lo analizamos en el Boletín: https://zuniv.net/pub/BOLETIN1Ambiente_13oct.pdf.
Los que logran sobrevivir al ataque del virus, se recuperan pero pueden quedar con un cuadro de fibrosis (cicatrización) pulmonar severo que disminuye la captacion de oxigeno y reduce su capacidad para hacer ejercicio. Es decir, quedan los pulmones con limitaciones. Ante estas circumstancias de insuficiencia respiratoria, el humo ocasionado por las quemas, es un factor seriamente agravante, que pone en riesgo la vida de los habitantes.
Mas aún, los pulmones de la naturaleza, son las plantas y los arboles que a traves de sus hojas y por la acción de los rayos solares generan el oxígeno en el planeta, a traves de un ciclo de metabolismo celular. Al destrozar estos “pulmones de la naturaleza”, por la quema, tambien se ve seriamente comprometido el medio ambiente de todo el planeta. Practicamente, todos los animales del planeta necesitan el oxígeno para sobrevivir. Es por eso que al igual que lo que se ha denominado Neumólisis a nivel pulmonar (de un micro-ambiente en nuestro cuerpos), debemos denominar Forestalisis (forestal=bosque, lisis = destrucción), Forestlysis en Inglés, a la destrucción de las plantas por la quema (de el macro-ambiente). Lo que, a su vez conlleva al compromiso de no solo la flora, sino también la fauna por agresión directa de las quemas y por la ausencia de fuentes de alimentación en base a plantas. FOTO (PERIODICO OPINION, 19 DE JULIO 2011)
En el COVID-19 el coronavirus destroza el pulmón del ser humano (Neumólisis) y produce la muerte. En los chaqueos (quema de los bosques) el ser humano destroza el pulmón de la naturaleza (Forestalisis). Esos irresponsables que prenden fuegos, son los “virus del planeta” y los que van a destrozarlo. Y de esta manera es un suicidio global comprometiendo nuestras vidas, todas nuestras plantas, todos nuestros animales, todo, absolutamente toda……… la vida!!!! Es por todo esto, ciudadanos bolivianos y de todo el mundo, que debemos dejar de producir chaqueos incontrolables, porque estamos hiriendo severamente a la madre tierra y esta Forestalisis (nuevo termino que invento), puede llevar a nuestro planeta a un éxito letal donde todos y cada uno de nosotros perderemos la más valiosa joya del universo: La vida!
Pulmonary Institute and Pathology at Altitude (IPPA)
We are again in October when our skies are filled with extraordinary solar rays throughout Bolivia, but…. ¿ Forest burning again? ¿ smoke again? Cities with polluted air? This planet is beautiful. It is the star product of the Universe. We have not yet discovered life outside the planet. Does everyone realize how extraordinary and fantastic this is? Technology and science have made great strides, without a doubt. Cell phones, computers, flight, even going to the moon. Remarkable achievements of intelligence, tenacity, the effort of great men. Nevertheless, those achievements in perspective, are infinitesimally insignificant compared to the greatness of nature. One of the essential elements of life is oxygen. Humans, the most intelligent living beings on the planet, and perhaps, although it sounds too daring, the entire Universe, we need this precious element: oxygen.
Interestingly, the oxygen we breathe was not produced on earth. Great explosions made it in space. The land was the winner of its distribution lottery and its mixture with suitable temperatures and other vital elements. It came through almost unlimited spaces to land on a planet with water, carbon, and all the other precious elements of life. However, oxygen is the most vital element, as it cannot be stored in the body. We can stop eating solids and survive for up to a month, stop drinking liquids, and survive one week. Nevertheless, to stop breathing (and inhaling oxygen) can only be done for about 3 to 5 minutes. If the air with 20.9% oxygen does not enter the lungs, we are facing death. That is why this precious item is priceless. It is worth more than gold because the coronavirus has amply demonstrated it. One could be the richest man on the planet, but if enough oxygen did not enter the blood to nourish the tissues and our brain, it was all over. It is the end despite being cast in a cradle of gold.
As a specialist in altitude medicine and having worked for 50 years alongside Father, Prof. Dr. Gustavo Zubieta-Castillo, founder of the Pulmonary Institute and Pathology at Height (IPPA), I consider it my pressing responsibility to give the most critical and urgent advice. Since the Pandemic in Wuhan, China started, I have been caught, as if in an avalanche, dedicating attention and all knowledge with my daughter Natalia, a doctor by profession at the scientific forefront created by this terrible Coronavirus-2 that triggers the disease called COVID -19. I received a kind invitation to participate in a radio program about the Coronavirus in January 2020. My first reaction was to reject the invitation because I affirmed that I was not an epidemiologist and I really did not know much about this disease, so I rejected the invitation and hanged up. Five minutes passed by, and they called me again. Again I heard the gentle voice of Jackeline Barriga, who had communicated my decision to Johny Villaroel, manager and program director Desarmado Discursivo. They again asked me to participate and give my opinion. A previous interview on the UMSA radio had pleased him, and he felt that I should participate, along with Dr. Nestor Taboada, the other interviewee. Reflecting, I accepted and changed the course of my attention and focused all my efforts to understand this terrible virus better to save lives.
The altiplano and Mt. Sajama
On the air, I proposed the idea that people infected with COVID-19 arriving to the airport of La Paz should be isolated in an adapted building away from the city and the altiplano. This, to prevent the progression of this terrible, highly transmissible disease. I also argued that ultraviolet radiation found at extreme levels at altitude would be an advantage over the coronavirus—that last statement, based on the concept of the advantages of ultraviolet radiation at high-altitude as anti-bacterial. This was exclaimed two years before, in a publication demonstrating the extended longevity of man at high-altitude, I compared to inhabitants of the lowlands, based on a study of data provided by SEGIP ( https://www.zuniv.net/pub/Longevidad_Espanol.pdf ).
Later on April 5, 2020, I published an article in La Razón in March, where I stated that ultra-violet radiation would protect us from COVID-19. As expected, the progression was slower in La Paz and El Alto initially. However, in July, there was an essential increase in cases, which in any case never reached those of Santa Cruz, although both departments have a similar number of inhabitants ( La Paz, 2.9 M and Santa Cruz 3.37 M ). This increase occurred because, in winter, ultraviolet radiation is at its lowest point. However, after the winter solstice, the ultraviolet radiation gradually increased, and concomitantly the cases of COVID-19 began to decrease, as we predicted. The incidence of mortality is also lower at altitude, as we confirmed with Dr. Freddy Armijo Subieta on several occasions. Without a doubt, high altitude is a protector against the coronavirus’s aggressiveness, not only due to environmental characteristics but also due to the biological characteristics of adaptation to high-altitude. We published several scientific articles in international journals on the matter. When the foreign publications stated that in New York, in the best-equipped hospitals globally, the mortality of those with ventilators was 88.7%, I asked myself: what is happening in the lungs with the aggression of this virus? I immediately realized that we were not facing a typical SARS type pneumonia, as experts from all over the world adduce. We were facing a new disease. I developed a new concept for everyone, pneumolysis, the destruction of lungs caused by the virus. For the first time at the first Coronavirus conference in India, I mentioned it where I was invited to participate and actively collaborated by inviting other colleagues. I mentioned the idea to the Italian intensivist Paolo Pelosi world authority on mechanical ventilation, during the conference on COVID-19 in India. He had treated multiple patients in intensive care units throughout the catastrophic pandemic in his country, and they still did not clearly understand what was happening. On July 9, 2020 (coinciding with the 50th anniversary of the IPPA), the newspaper El Diario interviewed me, and there I spoke in Bolivia for the first time about the Pneumolysis. Then I was invited to be co-chair director of the 2nd World Congress on Advances in COVID with Prof. Malali Gowda from the Bangalore Genomics Center in India. We held this successful event from August 27 to 30, 2020, with the presence of great scientists such as Dr. Andrew Pollard, a friend, director of the Oxford Vaccine, and Dr. Robert Gallo, one of the discoverers of the AIDS virus, among others notable scientists, whom I invited. There I explained in more detail pneumolysis and silent hypoxia (low oxygen), which can lead to sudden death. I spoke not only about microscopic studies but also about the pathophysiology of this terrible disease. Prof. Pelosi presented additional evidence of pneumolysis, confirming its existence. I invited him to participate in 2 conferences with me, here in La Paz. We also published with my daughter Natalia, about pneumolysis in the National Bioethics Bulletin, directed by Dr. Javier Luna Orozco.
The new concept, “Pneumolysis”, developed by me, about the serious commitment caused by the coronavirus in the current COVID-19 pandemic, constitutes a high-risk factor at this time. The coronavirus reaches the lung by inhalation and by entering through the pneumocytes’ ACE-2 receptors (respiratory cells in the lung) nests within. The RNA material of the virus is reproduced and destroys these cells: Pneumolysis (pneumo = lung, lysis = destruction).
The lung pneumolysis in COVID-19
That is why there is a severe injury to various parts of the lung (white areas on the tomography), causing a drop in the oxygen level, evidenced by the digital pulse oximeter. The patients’ lungs are gradually destroyed as the virus spreads, leading to “silent or silent hypoxemia.” Hypoxemia (hypo = low, oxemia = oxygen in the blood) measured with the pulse-oximeter. Returning to the forest burning started by people in the amazon areas. In these circumstances, the smoke in the environment is an incredibly aggravating factor compromising health, particularly those who do not have access to medicinal oxygen, which can cost them their lives. The smoke also blocks the entry of sunlight. Therefore, ultra-violet radiation protects us from the coronavirus, as I stated in the article: The advantages of ultra-violet radiation in controlling the coronavirus in high-altitude (La Razon, April 5, 2020) . Recently by suggestion of the Physicist Roberto Vera we analyzed this in the News Bulletin: ( https://zuniv.net/pub/BOLETIN1Ambiente_13oct.pdf).
Those who manage to survive the attack of the virus, recover. But they may be left with severe pulmonary fibrosis (scarring) that reduces oxygen uptake and reduces their ability to exercise. That is, the lungs are limited in their function. Faced with these circumstances of respiratory failure, the smoke caused by the burns is a seriously aggravating factor that puts the lives of the inhabitants at risk. Furthermore, the lungs of nature are the plants and trees that, through their leaves and by the action of the sun’s rays, generate oxygen on the planet through a cycle of cellular metabolism. By destroying these “lungs of nature” through forest burning, the entire planet’s environment is also seriously compromised. Virtually all animals on the planet need oxygen to survive. That is why, like what has been called Pneumolysis at the pulmonary level (of a micro-environment in our bodies ), we must call Forestalisis (forestal = forest, lysis = destruction), Forestlysis in English, to the destruction of the plants by burning (of the macro-environment). This leads to the compromise of flora and fauna due to direct aggression from burning and the absence of plant-based food sources. PHOTO (OPINION PERIODIC, JULY 19, 2011)
Chaqueo Bolivia
In COVID-19, the coronavirus destroys the human lung ( Pneumolysis ) and causes death. In the burning of the forests, the human being destroys the lung of nature (Forestalysis). The irresponsible people who set fires are the “viruses of the planet ” and those going to destroy it. And in this way, it is a global suicide compromising our lives, all our plants, all our animals, everything, absolutely all ……… life !!!! It is for all this, Bolivian citizens and citizens from all over the world, that we must stop generating uncontrollable fires. Because we are severely hurting mother earth and this Forestalisis (a new terminology that I invent), it can lead our planet to a lethal outcome where everyone and each of us will lose the most valuable jewel in the Universe: Life!
As the Cov-2 appeared in Wuhan, China and we first saw people falling dead in the streets, following a severe lung compromise, no one really understood what was happening. See here what happened:
Yes, many doubted, but it was true !! People died in the streets….. First in Wuhan and then all over the world.
The severe lung compromise in the lungs became evident in a lung scan,
and the fact that it was a Coronavirus, the world phycisians named it SARS-CoV-2, without second thoughts, i.e. Severe Acute Respiratory Syndrome. Hence is was named SARS-Cov-2 Pneumonia. And this carried on for several months throughout most of the year, with everyone rushing for the use of ventilators. Expensive ventilators were short in demand and rich and poor countries invested millions in order to obtain some. But were they on the right track?
Several started building respirators and among them, myself.
The total lockdown reduced the possibility of getting resources so being in Bolivia, I decided to build one, based on available materials. I designed the mechanism from a plastic ball found in a supermarket. I placed two flat square plates articulated with two hinges. A stepping motor was the driving force that moved the top plate up and down, and it was regulated by an arduino UNO, as the brain. I called a friend Rijard Ostermann who develops radars and has a team of collaborators with the idea of developing a small industry of respirators. I enthused him to work on this and we did so for about a couple of weeks. I sent him the video of the first prototype showing the ventilation effect.
But soon I realized that something was wrong. Not working right!
People were dying while on the ventilators and even 88.7% of those in New York top equiped Intensive Care Units, lost their lives. I then realized that ventilators were not of much use. I wrote a paper entitled:
Paper published on May 5, 2020 as a pre-print. over 1200 reads at pre-prints and Researchgate.net
Why was that? Evidently, no one understood the pathology, in other words, no one understood what the virus was doing to the lungs. As everyone knew, the virus attacked the pneumocytes and entered through the ACE-2 receptors. I then realized that the virus was causing what I first termed “Pneumolysis” and after about 2 weeks of thinking about it, I expressed it in public for the first time on June 7-19th 2020 (video available here) during in the International Conference on Corona Viral Genomics to Paolo Pelosi, the prestigious Italian intensivist. During the 2nd World Conference on Advances in COVID-19 organized by myself Prof. Dr. Gustavo Zubieta-Calleja representing our High Altitude Pulmonary and Pathology Institute (HPPAI-IPPA) and and Prof. Malai Gowda representing the Bengaluru Genomics Center in India, with convenors Dr. Pruthvi Chakravarthy and Dr. Natalia Zubieta-DeUrioste from both of our Institutions.
Bit this implies that everyone was treating a disease, all around the world, that they simply did not understand ?
Yes, and many lives could have been saved. But we tried to communicate it to the world, early on. With Natalia my M.D. daughter and immediate collaborator, we wrote a resumed short communication and submitted it to the Lancet on :
and their response was:
Lancet unable to accept for publication
We can understand that they are rejecting 99% of the papers as Prof. Murray Epstein has told me, however, we truly feel that this was a huge mistake. We are talking of saving people’s lives here. And this new concept is fundamental. Obviously, it was simply not understood.
So what should we do next ? Well lets try JAMA, but lets work on some changes and so we submitted:
And this time we included the term pneumolysis in the title. And what was the response?
And as we were getting worried that this could not move on we wrote:
Click on the image to read it (Spanish)
But a Bolivian Newspaper EL Diario also made me an interview:
But we needed a good article in a top international journal and it finally came:
However, there is also a pre-print of our next paper that is being peer-reviewed:
High Altitude Pulmonary and Pathology Institute in La Paz, Bolivia 3500m
As far as we know, we were the first in the world to propose that the U-V at high altitude would be a protective disinfectant in the COVID Pandemic. Originally, in Dec 2017 on a paper on Longevity at high altitude(Se ref. 1, below). Then I wrote a newspaper article about it when the Pandemic started to arrive in Bolivia on April 5th, 2020(3). My daughter Natalia Zubieta-DeUrioste, M.D., and I teamed up with another Bolivian Jorge Soliz Ph.D. and Christian Arias from Laval University who postulated that the lower amount of ACE2 receptors in the lungs at high altitude could also be a protective factor at high altitude. We participated in the U-V section. The other coauthors of that paper were several Bolivian Ph.D. students and an Australian Ph.D. (4). Likewise, we wrote of multiple diseases in COVID-19 early on May 5, 2020 (5) currently under peer review. Furthermore, I created the term “Pneumolysis” to describe what happens in COVID-19 and presented it for the first time in the INTERNATIONAL CONFERENCE ON CORONA VIRAL GENOME, in India (See the banner below). We feel proud to be able to contribute with our knowledge accumulated over 50 years of work at IPPA Just celebrated on July 9th, 2020, to this COVID Pandemic.
20. Winners of the 1st award of the Science and Technology in the area of Medicine and Pharmaceutical Sciences from the Ministry of Health in La Paz, Bolivia based on our publications on lower COVID at high altitude.
at Darwin 2020, one of India’s Biggest Evolutionary Movements in BiologyFue muy grato compartir con el Dr. Accinelli de distinguida Universidad Cayetano Heredia, en Lima, PerúEn Zoom 500 asistentes y en Facebook mas de 11,000. Click here to join on June 15, 2021
Yesterday on 01.05.2020, at 3.45 pm we had 7th weekly UNESCO COVID-19 Skype meeting.
The title was “The methods of detection of minimal therapeutic doses of drugs for COVID-19 therapy”
Italian Physician Dr. Foletti delivered a presentation on biophysical properties involved in renal functions based on ACE2 which is linked with SARS-COV-2.
There was outstanding input from Prof. Gustavo Zubieta a well-known pulmonologist from La Paz. Prof.Mubaseri, Dr. Sumanta Goswami and Dr. Md. Iqbal Alam contributed significantly on Molecular biology, clinical medicine, and computational biology to understand the deadly virus. 11 physicians and scientists participated in this 2h 30 mins meeting.
Happy to coordinate UNESCO Natural Science COVID-19 video conference under UNESCO Chair Life Science
Prof. Kusal Das BLDE University
Prof. Sinerik Ajrapetyan Dr. Hamid Mobasheri
Dr. Alberto Foletti Prof. Dr. Gustavo Zubieta-Calleja
As doctors with extensive experience in medical practice, we want to suggest the following initial treatment with the aim of trying to stop, the progression of the Coronavirus.
Currently, as we are all in quarantine, we can still catch a cold as usual. Nevertheless, if fever, body aches, and especially dry cough appear, we recommend the prompt application of the following treatment:
Pour some water in a saucepan, the smaller the better, pour until the water reaches about 1/5 cm high. Once the water boils, add 2 or 3 drops of IODINE. It can be bought at a pharmacy. By covering the top of your head with a towel, approach the pot taking care of not getting too close in order to avoid burning yourself and take slow deep breaths through your mouth, alternating with inspirations through your nose. Repeat the procedure several times in order to fill your respiratory tract with the iodine.
If you already feel the first symptoms, this can be practiced 2-3 times a day for about 2 minutes. You can also add about 2 leaves of Eucalyptus and/or chamomile flowers and continue another 2 minutes breathing deeply.
These home remedies have been very efficient in treating respiratory diseases for a long time.
IODINE is a formidable disinfectant and also an excellent mucolytic.
Eucalyptus has antibacterial properties and is also a perfume. It also has flavonoids (anti-oxidants) and tannins (anti-inflammatory).
Chamomile has anti-inflammatory properties.
At IPPA we used large vaporizing equipment that the late Prof. Dr. Gustavo Zubieta-Castillo (Sr) named “Thermo Fog”, which used a venturi tube to introduce the medicine in the vaporizer. There are also currently small commercial vaporizers that could be used in this way. But the use of the pot as described above, allows anyone with limited resources to receive this treatment.
The important thing is that this technique be applied when presenting any of the first symptoms of fever, malaise, body aches and especially cough.
We also recommend this to be done as soon as you come back home after going out in the quarantine, and after washing your hands as well as taking care of all the contaminated things you were carrying.
This technique could allow us in many cases, (although not in all) to slow down the progress of this terrible disease when it is still in the throat, trachea, bronchi and thus alleviate the overload of hospitals, which can be exceeded, as it is happening in many countries. The Bolivian Government has acted quickly, decreeing quarantine, which has allowed the level of infections to be non-explosive and Google has ranked us top in the quarantine application.
Be aware that some people can be allergic to iodine and should avoid it, but luckily there are not too many. It is important to note that for those with doubts, SENSITIVITY TO IODINE should first be tested with a drop of iodine placed on the mucosae or the skin on the interior of the mouth (pull out upper lip). If no reactions appear after 30 mins, the procedure is safe to carry out.
We make this medical recommendation in order to help the Bolivian population. A Bolivian woman in Spain reported on WhatsApp that this treatment helped her a lot to cope with her Coronavirus disease. Of course she is a young person, but she reported that it helped her breathe at the stage when there was already serious lung compromise. She was examined in a hospital but was sent to her home, where she achieved her full recovery. She did not use Iodine.
There is no scientific proof of the effectiveness of this procedure, however, centuries of experience treating colds, have taught us that it may have a favorable effect. Furthermore, since Coronavirus has a predilection for the alveolar cells, this seems a rational targeting strategy.
There are also other interesting factors that have been published on April 5, 2020 in the digital Bolivian newspaper La Razón. This article is about the wonderful protective effect of Ultra-Violet radiation in high-altitude cities in relation to the Coronavirus.
